Masticatory efficiency of implant-supported removable partial dental prostheses in patients with free fibula flap reconstructed mandibles: A split-mouth, observational study

Clin Oral Implants Res. 2018 Aug;29(8):855-863. doi: 10.1111/clr.13304. Epub 2018 Jun 19.


Objectives: The aim of this split-mouth study was to evaluate the masticatory efficiency in patients with segmentally reconstructed mandibles using free fibula flaps, with and without stabilizing osteosynthesis material in-situ during implant placement for rehabilitation with implant-supported removable partial dental prostheses (ISRPDPs).

Methods: Ten participants (n = 10; ♀ = 2, ♂ = 8; mean age = 38.1 years) consented to participate in this study. The participants' normal side (Side N) of the mandible served as the control side, for comparing the masticatory efficiency of the segmentally reconstructed and rehabilitated side (Side R). Masticatory efficiency was evaluated using the two-colored chewing gum test, measured as subjective assessment (SA) and electronically evaluated variance of hue (VOH). Data were checked for normal distribution and statistically analyzed with the level of significance set to p < 0.05.

Results: Thirty-four tissue-level implants were placed in reconstructed mandibles of 10 participants. There was no significant difference observed in the masticatory efficiencies between Side N and Side R, in both subjective and electronic assessments. No implant loss was observed after a post-rehabilitated mean follow-up period of 42.7 months, revealing an implant survival rate of 100%.

Conclusions: In patients with surgically reconstructed mandibles, a normal masticatory function can be successfully achieved with a rehabilitation of the reconstructed side with implant-supported removable partial dental prostheses. Implant-supported prostheses should be actively advocated in patients with reconstructive surgeries to restore their masticatory function, extend their food choices, and improve their overall oral health-related quality of life.

Keywords: chewing efficiency; free fibula graft; implant-supported removable partial dental prostheses; masticatory function; reconstructed mandible; segmentally resected mandible; two-color chewing gum test.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Bite Force
  • Dental Implantation, Endosseous
  • Dental Prosthesis, Implant-Supported*
  • Female
  • Fibula / transplantation*
  • Free Tissue Flaps
  • Humans
  • Male
  • Mandible / diagnostic imaging
  • Mandible / physiology
  • Mandible / surgery*
  • Mandibular Reconstruction / methods*
  • Mastication / physiology*
  • Middle Aged
  • Radiography, Panoramic
  • Randomized Controlled Trials as Topic